Registration Form

MASTA Travel Medicine Study Day 16 th November 2012
Registration Form
One form required per delegate (photocopy for multiple delegates)
Please complete and post back to the address at the bottom of the page along with your payment. All
registrations will be confirmed by post or email.
Early Bird Registration before 30 th September 2012 £100 plus VAT (£120)
Registration on or after 30 th September 2012 £125 plus VAT (£150)
PLEASE PRINT USING BLACK INK
Company Name/Affiliation:
Title:
Address:
Postcode:
Email:
Method of payment:
First Name:
Cheque – made payable to MASTA
Contact Number:
Surname:
Debit/Credit Card payment. Please call 0113 2387500 and ask to speak to our finance
department.
Invoice (for MASTA account holders only) Please quote account number: _______________
Please return your completed form to:
Nicola Davison
MASTA Ltd
Moorfield Road
Yeadon
Leeds
LS19 7YA
Tel: 0113 2387559 Fax: 0113 2387501
Email: nicola.davison@masta.org
If you are unable to attend once you have registered you may contact MASTA and substitute another delegate.
Cancellations less than 21 days before the conference are non refundable

MASTA Travel Medicine Study Day 16 th November 2012
The MASTA Travel Medicine Study Day will be held at the Royal College of Physicians,
London on Friday 16 th November 2012.
We always aim to cover interesting and topical subjects. On the programme so far:
• Bite prevention and personal protection measures
Dr James Logan, Department of Disease Control, London School of Hygiene and
Tropical Medicine
• Medico-legal issues
Dr Dipti Patel, Co-Director, NaTHNaC
• Mass gatherings
Liz Rosies, Travel Health Nurse Advisor
• Immunity and how vaccines work
Dr Ifeanyichukwu Okike, Paediatric Infectious Diseases Registrar, St George’s
University Hospital of London
• What’s new
Jane Chiodini, Independent Travel Health Specialist Nurse
• Malaria
Speaker to be confirmed
The Royal College of Physicians is an excellent venue in central London. A sit down
lunch will be provided for all delegates together with refreshments in the morning and
afternoon. Registration will be from 09.15 with opening remarks at 09.45.
If you would like to register as a delegate please complete the registration form.
If you are unable to attend once you have registered you may contact MASTA and substitute another delegate.
Cancellations less than 21 days before the conference are non refundable